More Screening Needed to Identify Depression

On the surface they appear unaffected, but people who have mild strokes may live with hidden disabilities, including depression, vision problems and difficulty thinking, according to a study.

The study calls for new guidelines for the treatment and management of mild strokes, which account for two-thirds of all strokes and usually involve a hospital stay of one to five days. Annie Rochette of the University of Montreal and her research team interviewed 200 people in Quebec, Ontario and Alberta within the first six weeks of their stroke.

"There is no such thing as a mild stroke," says Rochette, who describes high rates of sleeplessness and depression among study participants – almost a quarter of whom were clinically depressed. "These patients face huge challenges in their daily lives." Study participants reported a significantly poorer perceived quality of life.

Participants in the study were generally younger than people who have severe strokes. The mean age of study participants was 62. Seventy-five per cent of severe strokes occur in people over age 65.

People interviewed worried about returning to work (41 per cent were working before their stroke), taking care of their families and being able to drive. Yet, few were screened for visual or cognitive impairments, which are not as easily detected as impairments in movement, before leaving hospital or provided with post-stroke rehabilitation.

Nearly 25 per cent of mild stroke patients only visited the emergency room. Occupational therapists, neuropsychologists or speech therapists, who typically do these types of screenings, do not usually see mild stroke patients, says Rochette.

"Patients are told to see their family doctor, but given no other tools or rehabilitation," says Rochette. "When they go to drive again some people are too afraid to get behind the wheel."

People with mild stroke also faced the fear and increased risk of another stroke and uncertainty about the future. "This study dispels the myth that mild strokes lead to few or no consequences," Rochette says.